Stimulated saliva composition in patients with cancer of the head and neck region

Ulrica Almhöjd; Hulya Cevik-Aras; Niclas Karlsson; Jin Chuncheng; Annica Almståhl

doi:10.1186/s12903-021-01872-x

Stimulated saliva composition in patients with cancer of the head and neck region

BMC Oral Health. 2021 Oct 9;21(1):509. doi: 10.1186/s12903-021-01872-x.

Authors

Ulrica Almhöjd¹, Hulya Cevik-Aras^{2

3}, Niclas Karlsson⁴, Jin Chuncheng⁴, Annica Almståhl⁵

Affiliations

¹ Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
² Department of Oral Pathology and Medicine, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
³ NÄL Hospital, Trollhättan, Sweden.
⁴ BioMS, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁵ Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. annica.almstahl@odontologi.gu.se.

Abstract

Background: To analyse over time changes in stimulated whole saliva regarding total protein, Immunoglobulin A (IgA), and mucin type O-glycans (mostly MUC5B and MUC7) in head and neck cancer patients.

Methods: 29 dentate patients (20 men and 9 women, 59 ± 8 years) treated with curative radiation therapy and chemotherapy for cancer of the head and neck region were included. The stimulated whole salivary secretion rate was determined and saliva collected at four time-points: at pretreatment, and at 6 months, 1 and 2 years post treatment. The total protein concentration was determined spectrophotometrically by using Bicinchoninic Acid assay and Immunoglobulin A (IgA) by using ELISA technique. Glycosylation pattern of salivary mucins was determined in samples collected pre- and post treatment by using LC/MS electrospray and mucin content quantified using SDS-AgPAGE gels and PAS staining.

Results: Compared with pretreatment, the total protein concentration was increased already at 6 months post treatment (p < 0.01), and continued to increase up to 2 years post treatment (p < 0.001). During that period no significant changes in IgA concentration was detected. At pretreatment, the output/min of both total protein and IgA was significantly higher than at all time-points post treatment. Saliva from the cancer patients showed a low abundance/no detectable MUC7, while the MUC5B level remained, compared to saliva from a healthy control. The glycomic analysis showed that the percentage of core 2 O-glycans was increased as core 1, 3 and 4 O-glycans were decreased. The level of sialylation was higher at 6 months post treatment, while sulfation was lower.

Conclusion: A decreased output per minute of proteins at decreased salivary secretion rate, as well as reduced sulfation of MUC5B at 6 months post treatment tended to correlate with the patients' experience of sticky saliva and oral dryness. At 2 years post treatment, the decreased amount of IgA combined with a lowered salivary secretion rate indicate a reduced oral defense with increased risk of oral infections.

Keywords: Head and neck cancer; Immunoglobulin A; MUC5B; MUC7; O-Glycosylation; Salivary secretion rate; Stimulated whole saliva; Total protein.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Female
Head and Neck Neoplasms* / drug therapy
Humans
Male
Middle Aged
Mucin-5B
Mucins
Saliva* / chemistry
Salivary Proteins and Peptides
Salivation

Substances

MUC5B protein, human
MUC7 protein, human
Mucin-5B
Mucins
Salivary Proteins and Peptides